Chapter 6. LONG-TERM CONSEQUENCES
Back in 1928 Dr
Harrison Martland, a
medical examiner in
the US state of New Jersey,
published observations in
the Journal of the American
Medical Association about a
condition affecting boxers
–
notably “fighters of the
slugging type”. His article
was entitled Punch Drunk –
a term used around boxing
rings to describe men
who’d taken “considerable
head punishment”. They
had tremors, a dragging
foot or drooping hand,
hesitant speech and walked
with an unsteady gait.
It was the earliest published
record of what we now
call dementia pugilistica,
a disorder found in people
who have suffered repeated
concussions. Martland saw it
in boxers. But it has since been
observed in a range of people
who suffer head injuries,
such as professional athletes
in other sports and military
personnel exposed to combat.
A PROTEIN CALLED TAU
There is now evidence
that repeated concussions
could be associated with
the development in later
life of a particular kind
of degenerative disease
called chronic traumatic
encephalopathy (CTE).
This disorder has many
of the same physiological
hallmarks of forms of
dementia, including
Alzheimer’s disease,
particularly the abnormal
accumulation in the brain
of a protein called tau.
In a healthy brain, tau is
found in the axons – the
transmission lines – of
neurons, where it plays an
important role in maintaining
the structure of the internal
Dr Harrison Martland
Ultrasound can be used to transiently open the blood-brain
barrier in models of Alzheimer’s disease, activating the brain’s
waste disposal system and decreasing the build-up of amyloid
protein. Another protein that builds up in Alzheimer’s is tau,
which is also associated with chronic traumatic encephalopathy
(CTE). Evidence suggests that the risk of developing CTE may
be increased with repeated concussion.
ILLUSTRATIONNICKVALMAS